Albendazole Regimen for Adults in India
For intestinal helminth infections in adults in India, administer albendazole 400 mg as a single oral dose with food, repeated after 2 weeks for hookworm and pinworm infections. 1
Standard Single-Dose Regimen
Albendazole 400 mg orally as a single dose is the WHO-recommended standard treatment for common intestinal helminths including Ascaris lumbricoides (roundworm), hookworm species, and Enterobius vermicularis (pinworm) in adults. 1, 2
Always administer albendazole with food, preferably a fatty meal, to maximize systemic absorption and therapeutic efficacy. 1, 2
For pinworm (Enterobius) and hookworm infections specifically, repeat the 400 mg dose after 2 weeks to target newly matured adult worms. 1, 2
Extended Regimens for Specific Parasites
For hookworm infections requiring higher cure rates, extend treatment to albendazole 400 mg daily for 3 consecutive days, as single-dose therapy achieves only approximately 36% cure rates with an 86.7% egg-reduction rate. 2
For whipworm (Trichuris trichiura), switch to mebendazole 100 mg twice daily for 3 days combined with ivermectin 200 μg/kg once daily for 3 days, because single-dose albendazole achieves only 27–60% cure rates. 2, 3
Empirical Treatment for Undiagnosed Infections
When the specific helminth is unidentified but infection is suspected (e.g., eosinophilia, recent travel to endemic areas), combine albendazole 400 mg single dose with ivermectin 200 μg/kg single dose, repeated after 2 weeks. 1, 2
Before administering ivermectin, exclude Loa loa infection in patients from Central/West African endemic regions to prevent severe encephalopathy. 1, 2
Screen for or empirically treat Strongyloides stercoralis before initiating any corticosteroid therapy, as immunosuppression can precipitate fatal hyperinfection syndrome. 1, 2
Lymphatic Filariasis (Specific to India)
For Wuchereria bancrofti microfilaremics in India, the standard regimen combines albendazole 400 mg with diethylcarbamazine (DEC) 300 mg as a single annual dose. 4
Higher-dose regimens (albendazole 800 mg with DEC 300 mg) administered every 6 months show trends toward greater microfilarial clearance (76.9% at 24 months) compared to standard annual dosing (64% at 24 months), though differences are not dramatic. 4
Monitoring Requirements
No routine laboratory monitoring is required for single-dose or short-course regimens (<14 days). 1, 2
For treatment courses exceeding 14 days, obtain complete blood count and liver function tests at the start of each 28-day cycle and every 2 weeks during therapy, as leukopenia occurs in up to 10% and elevated liver enzymes in up to 16% of patients. 1, 2
Critical Pitfalls to Avoid
Never administer liquid paraffin (mineral oil) during albendazole treatment, as it significantly impairs drug absorption. 1
If tapeworm segments are observed or Taenia infection is suspected, use praziquantel 10 mg/kg as a single dose instead of albendazole. 2
When Taenia solium is identified, screen for neurocysticercosis using serology and fundoscopic examination before treatment, as intestinal infection may coexist with brain cysts requiring adjunctive corticosteroids and prolonged albendazole courses (15 mg/kg/day divided twice daily for 10–14 days). 1, 2